10035 PDF registration sheet design

I need to send out an online registration form as PDF to my beta test customers. I have created a word document with general layout - I am flexible with layout - it should be nicer and our logo and corporate identity needs to be added. PDF should have entry fields (don't have adobe acrobat here - you need it for it) and our customer will save and send it via mail to us and print out / sign it and fax it to us. We need to finish it tonight (or last draft tonight, so that I can send it out tomorrow morning).

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